SUBJECT:

Mora Medical Distributors, Inc.,

Petitioner,

Palmetto GBA and The National Supplier Clearinghouse.

DECISION

I reverse the determination of the Carrier Hearing Officer (Hearing Officer) to deny reinstatement of the supplier number assigned to Mora Medical Distributors, Inc. (Petitioner). I find that while the Hearing Officer's decision affirming the National Supplier Clearinghouse (NSC or Respondent) was proper at the time it was issued, Petitioner has corrected all deficiencies and is now entitled to receive a Medicare supplier enrollment number (supplier number). ⁽¹⁾

I. Background

Petitioner applied to the NSC for a Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) billing number. On October 26, 2004, NSC notified Petitioner that its supplier number would be revoked 15 days from the postmarked date of the letter. NSC determined that Petitioner was not in compliance with standard 1 or standard 10 of 42 C.F.R. � 424.57. By two letters, one dated November 4 and one dated November 17, 2004, Petitioner appealed the revocation. By a letter dated December 6, 2004, the NSC notified Petitioner that Petitioner's supplier number would remain revoked for its continued failure to comply with standard 1 and standard 10. By a letter dated January 10, 2004, Petitioner requested a hearing by the NSC. ⁽²⁾ Subsequently, Petitioner submitted documentation to the Hearing Officer that brought the company into compliance with supplier standard 10. By a decision dated January 20, 2005, the Hearing Officer decided that Petitioner was in compliance with standard 10 but remained out of compliance with supplier standard 1, and therefore, was not entitled to a supplier number. By a letter dated February 4, 2005, Petitioner filed a timely appeal of the NSC's denial.

II. Issue, findings of fact and conclusions of law

A. Issue

The issue in this case is whether Petitioner is entitled to a supplier number.

B. Findings of fact and conclusions of law

Petitioner has corrected all outstanding deficiencies, is now in compliance with all 21 Medicare supplier standards, and is entitled to a Medicare supplier enrollment number.

To qualify for a DMEPOS supplier number, a supplier must meet certain standards. Those standards are set forth at 42 C.F.R. � 424.57(c)(1) through (21). Standard 1 states: the supplier operates its business and furnishes Medicare-covered items in compliance with all applicable Federal and State licensure and regulatory requirements. 42 C.F.R. � 424.57(c)(1).

The Hearing Officer noted in her January 20, 2005 decision that because Petitioner would be supplying durable medical equipment and enteral nutrition, the State of California required that Petitioner have a valid and current Home Medical Device Retailer Exemptee License (Exemptee License). The Hearing Officer concluded that she was unable to recommend to the NSC that Petitioner's DMEPOS supplier number be reinstated because the hearing file did not contain a copy of the Exemptee License. Petitioner has now provided a copy of its Exemptee License, and is thus in compliance with standard 1. ⁽³⁾

I find that Petitioner is now in compliance with all 21 Medicare supplier standards, and is entitled to a Medicare supplier enrollment number.

Marion T. Silva

Chief Administrative Law Judge

1. NSC submitted the Hearing Officer's Administrative Record, which I admit as Respondent's Exhibit (R. Ex.) 1. Petitioner submitted its State of California Exemptee license, No. 17548, which I admit as P. Ex. 1.

2. The letter incorrectly reflected a date with the year 2004 instead of 2005.

3. A copy of the Exemptee License was faxed to NSC on March 16, 2005.